Chapter 5: Cultural Influences
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Q1) The culturally sensitive nurse will recognize that an older adult client with a high-context ethnic background will appreciate:
A)not having a treatment scheduled during her favorite television program.
B)both a written and verbal explanation describing how to monitor her blood sugar levels.
C)a concise explanation as to why her physical therapy appointment has been canceled.
D)having a conversation about her grandchildren while her dressing is changed.
Q2) The nurse in an assisted living facility is preparing to admit an older adult client who speaks very little English.The nurse decides that it is most important that an interpreter be present when the client:
A)indicates that she wants to talk with her physician.
B)is being oriented to the facility.
C)is required to sign official documents.
D)begins crying and is inconsolable.
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Chapter 6: Family Influences
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Q1) An older client with cognitive impairment is being cared for by family members.They have expressed concerns about providing appropriate care as his functional level declines.The nurse responds:
A)"I'm glad that you are interested enough in his care that you've expressed this concern."
B)"His abilities will certainly continue to decline. This is the time to discuss other care options."
C)"You are right to be concerned. Let's talk about what issues may come up as he declines further."
D)"The condition is going to worsen. You need to prepare yourselves for the time when you can't meet his needs alone."
Q2) An 80-year-old client with diminishing cognitive function is being discharged into the care of his 72-year-old wife.The nurse recognizes that besides the wife's physical ability to provide appropriate care, there is a need to evaluate the:
A)couple's financial resources.
B)couple's social support system.
C)wife's cognitive level of function.
D)client's long-term health prognosis.
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Chapter 7: Socioeconomic and Environmental Influences
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Q1) In order to best respect an older client's autonomy when assisting him in finding appropriate, affordable housing, the nurse:
A)provides examples of various options that include assistive services.
B)locates housing near senior citizen community center to minimize social isolation.
C)identifies housing close to the services he will need.
D)asks the client to provide examples of where he would like to live.
Q2) A nurse volunteers at a facility that provides free lunches for older adults.To best minimize the tendency of these clients to withdraw socially, the nurse:
A)frequently reinforces that everyone is welcome to have lunch with the group.
B)makes every effort to engage them in conversation during the meal.
C)encourages them to make friends with the other clients.
D)asks if they would assist those who need help with getting their food.
Q3) A nurse working with older adults recognizes that the client at greatest risk for homelessness is the:
A)female with a psychiatric diagnosis.
B)male with a chronic illness.
C)female with a history of social isolation.
D)male with an alcohol abuse issue.
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9
Chapter 8: Health Promotion and Illnessdisability
Prevention
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Q1) The primary focus of the Health Belief Model of health promotion is addressed when the nurse:
A)accompanies the assisted living residents on a walk before dinner.
B)asks a senior citizen group what free health screening they want made available to them.
C)plans a health education program on cooking with diabetic friendly meals in cooperation with a dietician.
D)asks the client if he believes smoking puts him at risk for lung cancer.
Q2) When the home health nurse assists the older adult client with rearranging furniture within the home to prevent the client from falling, the nurse is demonstrating:
A)health promotion.
B)health protection.
C)health prevention.
D)disease prevention.
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10
Chapter 11: Sleep and Activity
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Q1) The daughter of an older cognitively impaired client responds to the nurse's suggestion to keep her father physically active by stating, "Dad is so easily agitated it would be a major battle to take him on a walk." The nurse's initial response is based on the understanding that:
A)caregivers are often overwhelmed by the challenges of caring for such clients.
B)physical exercise has been proven helpful in managing anger in such clients.
C)exercise such as walking is likely to appeal to clients such as her father.
D)her father's general health and wellness will be positively affected by walking.
Q2) An 89-year-old reported to the clinic nurse that since his grandson moved in a few months ago, he has had problems sleeping.The nurse initiates the discussion about his problem by asking:
A)"How do you feel about having a roommate?"
B)"Was it your decision to invite him to move in with you?
C)"Has your sleep pattern changed since he moved in with you?"
D)"Can you be more specific about the trouble you have sleeping?"
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Chapter 12: Safety
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Q1) The geriatric nurse recognizes that the most effective intervention to minimize the potential of a fall injury for a 79-year-old client who is being discharged to home after hip replacement surgery is to:
A)identify the most common causes of falls that the client is likely to encounter.
B)discuss what kind of in-home assistance the client will need.
C)impress the client with the importance of being careful not to fall.
D)educate the client that falling is not a normal part of aging.
Q2) A 73-year-old client is diagnosed with bilateral osteoarthritis of the knees.To best address the long-term risk for falls, the nurse encourages the client to:
A)use assistive mobility devises when necessary.
B)report exacerbation of symptoms to her health care provider promptly.
C)add a daily walk to her routine to exercise her knees appropriately.
D)take analgesic medication as prescribed to manage joint pain.
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14
Chapter 13: Intimacy and Sexuality
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Sample Questions
Q1) Which statement made by a nurse reflects a lack of understanding regarding sexual intimacy and the older adult client?
A)"Older adults express less interest in intimacy as both acute and chronic illnesses develop."
B)"Sexual expression is considered an enhancement to the quality of the older adult's life."
C)"Expressing sexual needs may be difficult or impossible for some older adults."
D)"Interest in physical contact tends to persist throughout life for both genders."
Q2) Upon entering the room of a cognitively impaired older adult client, the nurse observes that he is exposed and rubbing his genitals.The nurse's initial concern is to:
A)alert staff to be aware of this new behavior.
B)provide the client with privacy.
C)assess him for possible pain and fever.
D)provide a verbal cue for him to stop the behavior.
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15
Chapter 15: Pain
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Sample Questions
Q1) Acetaminophen is prescribed for a 70-year-old with chronic pain.When the client reports to the nurse that she is taking the maximum daily dose of medication each day but the pain is still not controlled, the nurse responds:
A)"Breakthrough pain can be managed with the addition of another analgesic."
B)"Transcutaneous electrical nerve stimulation (TENS) is often helpful."
C)"It sounds as though you have developed a tolerance for acetaminophen."
D)"We will need to get your physician to prescribe another analgesic for you."
Q2) The nurse caring for an older adult client experiencing carpal tunnel syndrome anticipates the client will best achieve pain control when prescribed a(n):
A)narcotic (e.g., fentanyl).
B)opioid (e.g., oxycodone).
C)tricyclic antidepressant (e.g., amitriptyline [Elavil]).
D)nonpharmacologic strategy (e.g., wrist bracing).
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17
Chapter 16: Infection
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Q1) The geriatric nurse identifies the client with the greatest risk of immunosuppression as:
A)having a roommate infected with MRSA.
B)having numerous oral mucosal ulcers.
C)receiving treatment for rheumatoid arthritis.
D)being cognitively impaired.
Q2) A client who is currently being treated for rheumatoid arthritis exhibits symptoms suspicious of tuberculosis ( TB ).The nurse anticipates that:
A)the symptoms are a result of the client's rheumatoid arthritis.
B)the symptoms are actually side effects of corticosteroid therapy.
C)a chest radiograph will definitively confirm a diagnosis of TB.
D)a purified protein derivative ( PPD ) skin test will likely be negative.
Q3) The nurse caring for an older adult client engages in appropriate cancer-related health screening when which of the following occur? Select all that apply.
A)Preparing a client for a lung biopsy
B)Collecting a 24-hour urine specimen
C)Assisting a client schedule a mammogram
D)Drawing blood for a prostate sensitive antigen ( PSA ) test
E)Keeping a patient NPO for a scheduled colonoscopy
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Page 18
Chapter 17: Chronic Illness and Rehabilitation
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Sample Questions
Q1) An older client diagnosed with severe osteoarthritis has recently moved in with his son because of a history of falls.The son describes how he and his family have eagerly assumed responsibility for "meeting all Dad's needs." The nurse is most concerned that this environment will result in the client:
A)developing a sense of powerlessness and possibly a loss of hope.
B)becoming unnecessarily physically and emotionally dependent.
C)losing his will to "get better" and become independent again.
D)becoming resentful and argumentative with his son's family.
Q2) Adherence to prescribed health care treatments by a client with a chronic disease is best facilitated when the nurse does which of the following? Select all that apply.
A)Provides the client with information regarding his disease
B)Assesses the client's ability to understand his disease
C)Defines "health and wellness" for the client
D)Helps the client identify barriers to his personal wellness
E)Coordinates support services to facilitate the client's discharge
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19
Chapter 18: Substance Abuse
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Sample Questions
Q1) The nurse is caring for an older adult who reports severe chronic pain.To best assess age-related physiologic changes that could influence plans for initiating an appropriate drug regimen, the nurse prepares the client for which laboratory evaluation?
A)White blood count
B)Glomerular filtration rate
C)Serum complement level
D)Electroencephalogram
Q2) A 69-year-old was prescribed a benzodiazepine 3 years ago.This medication regimen increases the client's risk for injury related to drug abuse and requires frequent client assessment for:
A)daytime sleepy.
B)unsteady gait.
C)shortness of breath.
D)easy bleeding.
E)forgetfulness.
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Chapter 19: Cancer
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Sample Questions
Q1) An older adult client is undergoing palliative surgery for colon cancer metastasis.The nurse explains to the family that this intervention is intended to:
A)prolong the client's life by several months.
B)improve the effectiveness of the chemotherapy.
C)relieve the pain associated with spread of the tumor.
D)prevent further tumor growth.
Q2) When obtaining a health history, the nurse recognizes that an older adult client has a risk factor for colorectal cancer when he reports:
A)that he is a vegetarian who eats soy products.
B)that he often uses a laxative.
C)a history of inflammatory bowel disease.
D)that he has diarrhea at least monthly.
Q3) An older adult client diagnosed with colon cancer is being evaluated for surgical removal of the tumor.The nurse explains that the primary consideration is the:
A)absence of any chronic disorders.
B)absence of metastasis.
C)tumor's staging status.
D)client's presurgical health status.
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21
Chapter 20: Loss and End-Of-Life Issues
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Sample Questions
Q1) When a 66-year-old client dies as a result of surgical complications, the nurse begins to facilitate the family's acceptance of their loss by:
A)preparing each family member sufficiently prior to viewing the body of their loved one.
B)presenting the body of their loved one in an appropriate, respectful manner.
C)assuring them that the client received the best possible care post surgery.
D)providing them with an effective explanation of the problems that caused the client's death.
Q2) A 68-year-old client who has recently lost his wife of 50 years shares with the nurse that he'll, "never get over missing her." The nurse is most therapeutic when responding:
A)"We are here to help you anyway we can."
B)"Focus on the beautiful memories you have of her and your life together."
C)"Time will help you adjust to your loss."
D)"You'll never get over your loss but you can learn to live with it."
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22
Chapter 21: Laboratory and Diagnostic Tests
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Sample Questions
Q1) A 91-year-old client learns that his urine protein is 8.2 mg/100 mL.When asked to explain the significance of the result, the nurse replies:
A)"It may be elevated because of a urinary tract infection."
B)"The result is not significant since it's within normal limits."
C)"The level is usually elevated in people your age."
D)"Mild chronic renal failure causes a decrease in urine protein."
Q2) An older adult client has an elevated prostate-specific antigen ( PSA ) level.The nurse shares with him that a diagnosis of prostate cancer would be confirmed with an analysis of his:
A)alkaline phosphatase level.
B)acid phosphatase level.
C)serum amylase level.
D)uric acid level.
Q3) The nurse explains to an older client that the assessment of her thyroid health will require both a physical examination as well as laboratory test because:
A)thyroid studies are less accurate in older adults.
B)symptoms are similar to those caused by various infections.
C)it can be present without producing overt symptoms.
D)T3 levels are normally increased in aging.
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Page 23
Chapter 22: Pharmacologic Management
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Sample Questions
Q1) A 72-year-old client with a history of diabetes and hypothyroidism is being admitted to an assisted living facility.During the admission assessment the client reports difficulty falling asleep.The nurse shows an understanding of sleep dysfunction and the older client when asking:
A)"Have you ever been prescribed a sleeping medication?"
B)"How do you feel about leaving your home to live here?"
C)"How long have you been a diabetic?"
D)"Are you taking medication for your thyroid problem?
Q2) To minimize the possible complications of polypharmacy among older adult clients, the nurse assesses this population for which of the following? Select all that apply.
A)Number of physicians providing medical care
B)Location of pharmacies where prescriptions are filled
C)Presence of chronic illnesses
D)Tendency to borrow medication from family or friend
E)Use of over-the-counter medication to self-medicate
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Chapter 24: Respiratory Function
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Q1) When teaching older adult asthmatic clients techniques for improving their prognosis, the nurse stresses the importance of which of the following? Select all that apply.
A)Being alert for the early signs of breathing problems
B)Fostering an effective relationship with your healthcare provider
C)Identifying and avoid those things that are personal triggers
D)Incorporating regular rest periods into your daily routine
E)Increasing vitamin C consumption especially during winter months
Q2) The nurse is coordinating care for a newly admitted older adult diagnosed with hypertension, asthma, atrial fibrillation, mild osteoarthritis, and glaucoma.Before administering the client's newly prescribed corticosteroid medication, the nurse is especially interested in which of the following? Select all that apply.
A)The name of his hypertension medication
B)What he uses to manage his arthritic pain
C)Whether he feels his asthma is well controlled
D)Whether he takes his low-dose aspirin regularly
E)Whether he has ever had glaucoma-related surgery
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Chapter 25: Endocrine Function
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Sample Questions
Q1) Aware that older adult clients often present with nonclassic symptoms of type 2 diabetes mellitus, the nurse is particularly suspicious of a client reporting:
A)bouts of diarrhea alternating with periods of constipation.
B)recent problems reading and an infected sore on his toe that won't heal.
C)periods of depression and severe indigestion after eating.
D)dizziness when getting up too quickly and a red rash on the hands.
Q2) The nurse caring for an older adult with type 2 diabetes mellitus places importance on assessing the client for:
A)painful nodules on the fingers and toes.
B)reddened rash and brittle nails on the hands.
C)heartburn and flatus after meals.
D)skin temperature and hair growth pattern on the legs.
Q3) The nurse recognizes that an older adult on both antihypertensive and antidepressant drug therapies has a specific need for:
A)regular blood pressure monitoring.
B)an effective history focusing on sexual function.
C)an increase in daily fluid intake.
D)frequent assessment of emotional stability.
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Chapter 26: Gastrointestinal Function
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Q1) An older adult reports chronic constipation.When asked why this problem has gotten worse with age, the nurse responds:
A)"As we age our body requires increasingly more fiber to bring about healthy bowel function."
B)"We need to discuss the proper use of laxatives to best minimize the reoccurrence of constipation"
C)"It's possible that you have lost the ability to feel when you need to move your bowels."
D)"Aging brings about decreased gastric motility that often results in constipation."
Q2) A 70-year-old client has lost 25 pounds since being diagnosed with hepatitis A.To best manage the client's anorexia, the nurse suggests (select all that apply):
A)protein powder supplement added to the client's liquids.
B)several high-calorie, low-fat meals daily.
C)megavitamins that include iron and folic acid.
D)a thorough dietary assessment to identify favorite foods.
E)a high-protein diet.
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28
Chapter 27: Musculoskeletal Function
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Sample Questions
Q1) To best identify a risk for injury resulting in hospitalization of an older adult client who has experienced evidence of musculoskeletal aging, the nurse assesses for:
A)decreased muscle mass in the legs.
B)history of falls.
C)hyperextension of the spine.
D)decreased bone density of the spine and long bones.
Q2) The nurse caring for an older adult client prescribed allopurinol (Zyloprim) minimizes the client's risk for developing a serious outcome of this therapy by:
A)offering him fresh, cold water frequently during the day.
B)monitoring temperature every 4 hours.
C)ensuring sufficient protein intake.
D)assessing for depression symptoms daily.
Q3) An effective nursing activity to reduce the risk of hip dislocation after hip replacement surgery in the older adult client is for the nurse to:
A)instruct staff to use a fracture pan when the client needs to toilet.
B)administer ordered pain medication prior to turning.
C)elevate the client's knee on the affected side with a pillow.
D)apply an abduction splint while the client is in bed.
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29
Chapter 28: Urinary Function
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Sample Questions
Q1) An older adult client reports "losing urine" when she bends over or gets out of a chair.In light of her symptoms, the nurse edits the client's care plan to include Altered urinary function, __________ incontinence.
A)overflow
B)urge
C)functional
D)stress
Q2) When assessing the client for urinary incontinence, which client symptom best supports the nursing diagnosis of overflow incontinence?
A)"I have small accidents ever since I developed a cystocele."
B)"It burns so badly after I urinate that I hold it as long as I can."
C)"I can't make it to the toilet when I feel the need to urinate."
D)"I dribble urine almost constantly."
Q3) An older adult woman has a resistant strain of pneumonia.To best minimize her risk of developing acute renal failure, the nurse:
A)monitors the client's serum BUN levels via diagnostic laboratory work.
B)helps the client select low sodium foods from her daily menu.
C)offers the client a drink at least every 2 hours while she is awake.
D)measures and records the client's urinary output.
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Page 30
Chapter 29: Cognitive and Neurologic Function
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Sample Questions
Q1) An 80-year-old client exhibiting signs of dementia representative of Alzheimer's disease ( AD ).The nurse supports that possibility when determining that the client:
A)experienced a gastric resection several years ago.
B)traveled often to third world countries.
C)was employed as a steelworker for 40 years.
D)has a history of viral encephalitis.
Q2) The nurse educates the older client on the possible risks for injury related to the common age-related changes to the senses by stressing the importance of:
A)installing auditory smoke alarms.
B)having regular eye checkups.
C)being aware that hearing acuity decreases with age.
D)checking the expiration dates on foods such as dairy.
Q3) When assessing an older client displaying symptoms reflective of delirium, the nurse focuses the assessment on:
A)the degree and duration of the symptoms.
B)the amount of self-care deficiency the symptoms cause.
C)identifying processes that commonly result in the symptoms.
D)physiological dysfunction resulting from the symptoms.
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Chapter 30: Integumentary Function
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Sample Questions
Q1) An older adult client reports simple xerosis with mild pruritus.The nurse educates her on the importance of:
A)Applying an lanolin rich cream and avoiding scratching the areas.
B)Taking warm baths and gently rubbing of affected areas with a terry cloth towel.
C)Minimizing ingestion of fried foods and use of an antihistamine cream.
D)Avoiding bath oils and allowing the skin to air dry after bathing.
Q2) When assessing for squamous cell cancer, a home health nurse is particularly concerned about a suspicious lesion on the:
A)leg of a 60-year-old Asian female.
B)neck of a 73-year-old Hispanic female.
C)Lower lip of a 70-year-old African-American male.
D)back of a 90-year-old Caucasian male.
Q3) A 65-year-old man is seen in the outpatient clinic for treatment of psoriasis.The nurse educates the client to the possibility that he may develop:
A)alopecia.
B)orange-tinged urine.
C)yellow-brown nails.
D)cherry angiomas.
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32
Chapter 31: Sensory Function
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Sample Questions
Q1) An older adult client reports "ringing" in her ears.What additional data should the nurse gather to help determine the cause of the client's problem?
A)History of ear surgery
B)Use of prescription medications
C)Exercise and sleep patterns
D)Nutritional status, especially protein intake
Q2) An older adult diagnosed with Ménière's disease is prescribed meclizine (Antivert) and hydrochlorothiazide (HCTZ).The nurse's educational instructions include which of the following? Select all that apply.
A)The need to avoid alcoholic beverages
B)Instructions to take the medication with food
C)Symptoms of electrolyte imbalances
D)That drowsiness is a common side effect
E)Stopping the medication if chest pain occurs
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